Abstract

Aims

We conducted a cross-sectional survey to estimate the prevalence and clinical manifestation of disulfiram ethanol reaction (DER) and isopropanol toxicity (IT) in patients with alcohol use disorders, on disulfiram. Alcohol-based hand rub contains either ethanol or isopropanol or both. COVID-19 pandemic has led to wide scale usage of sanitizers. Patients with alcohol use disorders, on disulfiram, might experience disulfiram ethanol like reactions with alcohol-based sanitizers.

Methods

We telephonically contacted 339 patients, prescribed disulfiram between January 2014 and March 2020. The assessment pertained to the last 3 months (i.e. third week of March to third week of June 2020).

Result

The sample consisted of middle-aged men with a mean 16 years of alcohol dependence. Among the 82 (24%) patients adherent to disulfiram, 42 (12.3%) were using alcohol-based hand rubs. Out of these, a total of eight patients (19%; 95% CI 9–33) had features suggestive of DER; four of whom also had features indicative of IT. Five patients (62.5%) had mild and self-limiting symptoms. Severe systemic reactions were experienced by three (37.5%). Severe reactions were observed with exposure to sanitizers in greater amounts, on moist skin or through inhalation.

Conclusion

Patients on disulfiram should be advised to use alternate methods of hand hygiene.

中文翻译：

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双硫仑乙醇与酒精型洗手液的反应：一项探索性研究

摘要

目的

我们进行了一项横断面调查，以评估双硫仑的酒精使用障碍患者中双硫仑乙醇反应（DER）和异丙醇毒性（IT）的患病率和临床表现。酒精基手擦含有乙醇或异丙醇或两者。COVID-19大流行导致了消毒剂的广泛使用。服用双硫仑的酒精使用障碍患者可能会经历双硫仑乙醇，例如与基于酒精的消毒剂发生反应。

方法

在2014年1月至2020年3月期间，我们通过电话联系了339名处方了双硫仑的患者。评估涉及最近3个月（即3月的第三周至2020年6月的第三周）。

结果

样本包括平均酒精依赖时间为16年的中年男性。在82名（24％）坚持使用双硫仑的患者中，有42名（12.3％）使用了基于酒精的手擦。其中，共有8例患者（19％； 95％CI 9–33）具有提示DER的特征。其中四个还具有指示IT的功能。五名患者（62.5％）出现轻度和自限性症状。严重的全身反应发生了三（37.5％）。大量接触消毒剂，在潮湿皮肤上或通过吸入会观察到严重反应。

结论

应该建议使用双硫仑的患者使用其他手部卫生方法。